crossing96/oncoscreening huggingface dataset:
Development and psychometric evaluation of a patient-reported symptom index for patients with non-muscle invasive bladder cancer: the NMIBC-SI.	BACKGROUND AND OBJECTIVE: Non-muscle invasive bladder cancer (NMIBC) is a chronic condition requiring frequent follow-up with endoscopic examinations, tumour resections and intravesical treatments. In this clinical context, patient-reported outcomes (PROs) have enormous potential to inform treatment assessment and recommendations for NMIBC. We aimed to develop and evaluate a patient-reported NMIBC Symptom Index (NMIBC-SI) to facilitate clinical research and enhance care. METHODS: NMIBC-SI items were developed based on existing literature and qualitative interviews with patients and clinicians, and evaluated in two field tests: item reduction, using NMIBC-SI data from 220 patients on active treatment from nine Australian centres; reliability and validity evaluation of item-reduced version using NMIBC-SI data from 232 patients from five countries. RESULTS: NMIBC-SI assesses disease and treatment-related symptom burden and two treatment-specific side-effects (cystoscopy, intravesical BCG/Chemotherapy). Composite analysis supported a single composite model including core symptom and cystoscopy index items (Intravesical index items were not tested due to small sample). Test-retest reliability was strong (range 0.894-0.91). As expected, the NMIBC-SI was able to discriminate between no treatment and any treatment groups, and no treatment and chemo/BCG groups, providing evidence towards validity. CONCLUSIONS AND CLINICAL IMPLICATIONS: NMIBC-SI assesses patients' self-reported symptom burden and can be used to evaluate NMIBC treatments from the perspective of patients. The NMIBC-SI is acceptable to patients and has evidence for reliability and validity. Future validation work with patients with greater symptom burden is warranted.	bladder
Intravesical BCG: A Double-Edged Sword? The Untold Story of Infection Risks.	Background and Objectives: Intravesical Bacillus Calmette-Guérin (BCG) therapy remains a cornerstone in the treatment of non-muscle-invasive bladder carcinoma due to its efficacy in reducing recurrence and progression rates. However, its use is associated with various complications-including urinary tract infections (UTIs)-which necessitates further exploration. This study aims to analyze UTIs occurring during intravesical BCG treatment, emphasizing the microbial spectrum, resistance patterns, and risk factors from an infectious diseases and clinical microbiology perspective. Materials and Methods: A retrospective analysis was conducted on 240 patients diagnosed with non-muscle-invasive bladder carcinoma who received intravesical BCG therapy between 2010 and 2021. Data were collected from hospital records, including demographic characteristics, comorbidities, number of intravesical BCG cycles, and microbiological findings. UTIs were classified based on susceptibility patterns, and statistical analyses were performed to determine associations between clinical variables and UTI risk. Results: UTIs developed in 39.1% (n = 94) of patients, with 25.8% (n = 62) caused by susceptible pathogens and 13.3% (n = 32) by resistant pathogens. The most common causative agent was Escherichia coli (80.7% in susceptible UTIs, 43.8% in resistant UTIs), followed by Pseudomonas aeruginosa and Klebsiella pneumoniae. The presence of diabetes mellitus and chronic kidney disease significantly increased the risk of developing a UTI (p < 0.05). A higher number of intravesical BCG cycles correlated with increased UTI occurrence (p < 0.001). Serum C-reactive protein (CRP) levels were significantly elevated in patients with resistant UTIs, while procalcitonin levels were not a reliable predictor of UTI occurrence. Conclusions: Intravesical BCG therapy is associated with a significant incidence of UTIs, particularly among patients with predisposing comorbidities. The increasing prevalence of antibiotic-resistant infections underscores the need for careful monitoring and targeted antimicrobial stewardship strategies. CRP may serve as a useful adjunctive marker for UTI diagnosis in this setting. Future studies should focus on optimizing infection control measures and refining diagnostic criteria to differentiate between BCG-related inflammation and infectious complications.	bladder
Detection and agreement of blood- and lymph vessel invasion assessed by immunohistochemistry in matched TURBT and radical cystectomy specimens.	Vessel invasion (VI) in transurethral resection of bladder tumor (TURBT) usually assessed without immunohistochemistry (IHC) is associated with nodal metastases and reduced survival. Separation of blood (BVI) and lymph (LVI) vessel invasion by IHC in cystectomy (RC) suggests different prognostic trajectories and could guide management after TURBT. However, prevalence of BVI and LVI in TURBT and accuracy between TURBT and RC has not been thoroughly evaluated. We aimed to examine the prevalence of VI, BVI and LVI in TURBT using IHC, and investigate their agreement across matched TURBT and RC. We reviewed TURBT specimens from 244 patients later treated with RC with respect to VI on routine sections. On one selected block for each case D2-40/CD31 antibodies were applied. Accuracy of VI status was assessed comparing the corresponding RC results, and the differences across specimen types were assessed using McNemar´s test. In TURBT, more VI was detected with IHC (43 % vs. 31 %). The prevalences were 20 % BVI and 31 % LVI. BVI was associated with higher pathological stages on RC whereas LVI was associated with more nodal metastases. LVI showed good concordance. BVI showed low concordance overall but compared well in patients with MIBC and patients clinically assessed with non-organ confined disease. Our findings indicate that IHC in TURBT is a reliable tool, enabling increased VI detection and showing concordance of VI status between matched TURBT and RC. IHC may hold an improved prognostic potential as differentiating of BVI and LVI could contribute to better risk stratification at the time of TURBT.	bladder
Copper(II) Complexes of Pyrazolopyrimidine Derivatives as Anticancer Agents with Enhanced Chemodynamic Therapy through Bimodal Apoptosis and Ferroptosis.	We reported 10 new copper(II) complexes 1-10 with pyrazolopyrimidine derivatives as ligands. Complexes 2 and 4 reacted with glutathione (GSH) in cells through Fenton-like reaction to generate highly toxic hydroxyl radical (·OH) for chemodynamic therapy (CDT), and reduced endogenous glutathione peroxidase 4 (GPX4) to induce ferroptosis. In addition, these complexes effectively caused mitochondrial dysfunction and induced apoptosis and autophagy in tumor cells. Furthermore, 2 and 4 effectively inhibited the bladder cancer cell growth in a xenograft model. This study presents new copper(II) complexes that can significantly induce bladder cancer cells death by enhanced CDT through bimodal apoptosis and ferroptosis, providing a promising approach for cancer therapy.	bladder
XIAP promotes metastasis of bladder cancer cells by ubiquitylating YTHDC1.	X-linked inhibitor of apoptosis protein (XIAP), a member of the IAP family, is overexpressed in a variety of tumors and plays an important role in tumor progression. Increasing evidence suggests that XIAP promotes metastasis of bladder cancer but the underlying mechanism is not very clear. The RNA N6-methyladenosine (m(6)A) reader YTHDC1 regulates RNA splicing, nuclear transport, and mRNA stability and is a potential tumor target; however, its ubiquitin E3 ligase has not been described. In this study, screening of proteins that specifically interact with XIAP identified YTHDC1 as its degradation substrate. Ectopic overexpression of XIAP promoted degradation of YTHDC1, and knockout of XIAP upregulated YTHDC1, which inhibited metastasis of bladder cancer. Furthermore, YTHDC1 reduced the expression of matrix metalloproteinase-2 (MMP-2) by destabilizing its mRNA. These experiments revealed that XIAP promotes ubiquitination of YTHDC1, positively regulating expression of the MMP-2 and promoting metastasis of bladder cancer. Collectively, these findings demonstrate that XIAP is a critical regulator of YTHDC1 and pinpoint the XIAP/YTHDC1/MMP-2 axis as a promising target for the treatment of bladder cancer.	bladder
Preoperative prediction of muscle invasion in bladder cancer in the Indian population using the Vesical Imaging-Reporting and Data System (VI-RADS) score and individual multiparametric magnetic resonance imaging (MRI) characteristics.	AIM: This study aimed to prospectively validate the Vesical Imaging-Reporting and Data System (VI-RADS) score in the preoperative prediction of muscle invasion in bladder cancer in the Indian population. MATERIALS AND METHODS: The study prospectively reviewed patients with bladder masses who underwent 1.5T multiparametric magnetic resonance imaging between December 2018 and April 2023. Clinical and pathological data were collected, and bladder tumors were evaluated using a 5-point VI-RADS scoring system. Independent measurements of quantitative parameters (maximum tumor diameter [DMax] and tumor contact length [TCL]) were performed. These parameters and VI-RADS scores were compared to postoperative pathology to assess muscle invasion. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated using a cutoff score of 4. Receiver Operating Characteristic (ROC) analysis evaluated the diagnostic performance of quantitative values. RESULTS: A total of 55 patients were included in the analysis, of whom 36 were non-muscle invasive and 19 were muscle invasive on the final histopathological report. A VI-RADS score of ≥4 as the cutoff for muscle invasion yielded a sensitivity and specificity of 94.7% (95% CI 72.7%-99.9%) and 97.2% (95% CI 85%-99.9%), with PPV and NPV value of 94.7% and 97.2%, respectively. The receiver operating curve showed an area under the curve (AUC) of 0.958 (95% CI 0.89-1.0). The AUC of TCL and TCL/DMax values for muscle invasion were 0.811 and 0.835, respectively. CONCLUSIONS: The VI-RADS scoring system, qualitative parameters, as well as the TCL and TCL/Dmax exhibits a strong correlation with pathological staging, indicating to be an effective method for the preoperative determination of muscle invasion in bladder cancer.	bladder
A Genome-Wide Synthetic Lethal Screen Identifies Spermidine Synthase as a Target to Enhance Erdafitinib Efficacy in FGFR-Mutant Bladder Cancer.	Mutations of the FGFR family members are frequently observed in metastatic bladder cancer. The development of erdafitinib, a pan-FGFR inhibitor, provided a significant therapeutic advance in bladder cancer, but resistance still limits its efficacy. In this study, we performed an unbiased whole-genome CRISPR-Cas9 synthetic lethal screen on FGFR-mutant bladder cancer cell lines treated with erdafitinib and identified spermidine synthase (SRM) as a critical contributor to erdafitinib resistance. Moreover, hypusinated eIF5A, catalyzed by SRM-mediated spermidine production, facilitated the efficient translation of HMGA2, which in turn promoted the expression of EGFR. Notably, pharmacologic inhibition of SRM enhanced the efficacy of erdafitinib both in vitro and in vivo. Together, these results offer evidence that targeting SRM could attenuate the translation of HMGA2 and subsequently reduce EGFR transcription, thus enhancing the sensitivity of FGFR-mutant bladder cancer cells to erdafitinib treatment. SIGNIFICANCE: Combined inhibition of polyamine metabolism and FGFR is a promising therapeutic strategy to overcome erdafitinib resistance and improve treatment for patients with FGFR-mutant bladder cancer.	bladder
Machine Learning and Mendelian Randomization Reveal a Tumor Immune Cell Profile for Predicting Bladder Cancer Risk and Immunotherapy Outcomes.	This study's objective was to develop predictive models for bladder cancer (BLCA) using tumor infiltrated immune cell (TIIC)-related genes. Multiple RNA expression data and scRNA-seq were downloaded from the TCGA and GEO databases. A tissue specificity index was calculated and a computational framework developed to identify TIIC signature scores based on three algorithms. Univariate Cox analysis was performed, and the TIIC-related model was generated by 20 machine learning algorithms. A significant correlation between TIIC signature score and survival status, tumor stage, and TNM staging system was found. Patients in the high-score BLCA group had more favorable survival outcomes and enhanced response to PD-L1 immunotherapy as compared to those in the low-score group. This TIIC model showed better performance in prognosing BLCA. Diverse frequencies of mutations were observed in human chromosomes across groups categorized by TIIC score. No statistically significant correlation was observed between noncancerous bladder conditions and BLCA when examining the single nucleotide polymorphisms (SNPs) associated with the genes in the prognostic model. However, a statistically significant association was found at the SNP sites of rs3763840. There was no significant association between bladder stones and BLCA, but there was a significant association on the SNP sites of rs3763840. A novel TIIC signature score was constructed for the prognosis and immunotherapy for BLCA, which offers direction for predicting overall survival of patients with BLCA.	bladder
MiR-125b suppresses bladder Cancer cell growth and triggers apoptosis by regulating IL-6/IL-6R/STAT3 axis in vitro and in vivo.	Bladder cancer (BLCA) is an aggressive malignancy characterized by limited therapeutic options and a poor prognosis. Research has indicated that abnormally expressed miRNAs play a significant role in the pathogenesis of BLCA, although the specific mechanisms remain unclear. MiR-125b plays a tumor suppressor role in a variety of cancers and affects the biological processes of cancer cells such as proliferation, invasion, migration and apoptosis by regulating different signaling pathways. Elucidation of the molecular mechanisms underlying miR-125b may provide clinical therapeutic strategies for bladder cancer. Here, miR-125b was downregulated whereas its targets IL-6R and STAT3 were upregulated in BLCA, as evidenced by bioinformatics analysis. Kaplan-Meier analysis confirmed that miR-125b serves as an independent prognostic factor linked to overall survival (OS) in patients with bladder cancer. Furthermore, overexpression of miR-125b significantly inhibited BLCA cell proliferation, migration, and invasion, while promoting apoptosis, as evidenced by an increased Bax/Bcl-2 ratio and activated cleaved caspase-3. Further investigations demonstrated that miR-125b directly targets and downregulates both IL-6R and STAT3. In a xenograft model, miR-125b overexpression effectively inhibited tumor growth in bladder cancer by blocking IL-6/IL-6R and STAT3 signaling pathways. Collectively, these findings broaden our understanding of the mechanism by which miR-125b acting as a BLCA suppressor in apoptotic regulation by targeting the IL-6/IL-6R/STAT3 signaling pathway, providing novel insights regarding the design of novel miRNA based therapeutic strategies against BLCA.	bladder
Acute kidney disease after radical cystectomy for bladder cancer: a new onco-nephrological view.	OBJECTIVE: To assess the incidence of acute kidney injury (AKI) and acute kidney disease (AKD) following radical cystectomy (RC) in patients with muscle-invasive bladder cancer (BCa). MATERIALS AND METHODS: A consecutive cohort of 840 patients undergoing RC for muscle-invasive BCa at a tertiary institution (2010-2022) was analysed. Clinical variables, comorbidities, surgical techniques and oncological regimens were recorded pre- and post-surgery. Serum creatinine and estimated glomerular filtration rate (eGFR) were assessed at baseline, at 24, 48 and 72 h, and 6 days post-surgery for AKI, and at multiple intervals up to 60 days for AKD. Chronic kidney disease (CKD) stages G1 G2 and ≥G3 were classified according to the Kidney Disease Improving Global Outcomes (KDIGO) guidelines. A multivariable logistic regression model was used to predict postoperative AKI or AKD risk. RESULTS: Of the patients included in the study, 33% developed AKI and 54% developed AKD. Independent predictors included advanced age (odds ratio [OR] 1.05, 95% confidence interval [CI] 1.03-1.08), chronic hypertension (OR 1.43, 95% CI 1.03-2.00) and Charlson Comorbidity Index ≥2 (OR 1.59, 95% CI 1.09-2.33). Surgical factors, including use of a robot-assisted approach (OR 2.28, 95% CI 1.50-3.49) and ileal neobladder diversion (OR 1.84, 95% CI 1.05-3.24) were significant, possibly due to the associated prolonged operating times and metabolic challenges. Baseline renal function (CKD ≥G3, OR 2.17, 95% CI 1.28-3.68) and lower preoperative eGFR strongly correlated with AKD risk; a baseline eGFR below 20 mL/min was associated with an AKD risk ≥80%. CONCLUSION: Our results showed that AKI and AKD are frequent complications of RC for muscle-invasive BCa. Personalised nephrological counselling pre- and post-surgery is essential to minimise morbidity and mortality.	bladder
Using machine learning for predicting cancer-specific mortality in bladder cancer patients undergoing radical cystectomy: a SEER-based study.	BACKGROUND: Accurately assessing the prognosis of bladder cancer patients after radical cystectomy has important clinical and research implications. Current models, based on traditional statistical approaches and complex variables, have limited performance. We aimed to develop a machine learning (ML)-based prognostic model to predict 5-year cancer-specific mortality (CSM) in bladder cancer patients undergoing radical cystectomy, and compare its performance with current validated models. METHODS: Patients were selected from the Surveillance, Epidemiology, and End Results database and the First Affiliated Hospital of Sun Yat-sen University for model construction and validation. We used univariate and multivariate Cox regression to select variables with independent prognostic significance for inclusion in the model's construction. Six ML algorithms and Cox proportional hazards regression were used to construct prediction models. Concordance index (C-index) and Brier scores were used to compare the discrimination and calibration of these models. The Shapley additive explanation method was used to explain the best-performing model. Finally, we compared this model with three existing prognostic models in urothelial carcinoma patients using C-index, area under the receiver operating characteristic curve (AUC), Brier scores, calibration curves, and decision curve analysis (DCA). RESULTS: This study included 8,380 patients, with 6,656 in the training set, 1,664 in the internal validation set, and 60 in the external validation set. Eight features were ultimately identified to build models. The Light Gradient Boosting Machine (LightGBM) model showed the best performance in predicting 5-year CSM in bladder cancer patients undergoing radical cystectomy (internal validation: C-index = 0.723, Brier score = 0.191; external validation: C-index = 0.791, Brier score = 0.134). The lymph node density and tumor stage have the most significant impact on the prediction. In comparison with current validated models, our model also demonstrated the best discrimination and calibration (internal validation: C-index = 0.718, AUC = 0.779, Brier score = 0.191; external validation: C-index = 0.789, AUC = 0.884, Brier score = 0.137). Finally, calibration curves and DCA exhibited better predictive performance as well. CONCLUSIONS: We successfully developed an explainable ML model for predicting 5-year CSM after radical cystectomy in bladder cancer patients, and it demonstrated better performance compared to existing models.	bladder
"Robot-assisted radical cystectomy with the clinical application of ""Y-shaped"" end-to-side ureteral anastomosis in elderly and obese patients."	"OBJECTIVE: To investigate the clinical effect and safety of ""Y-shaped"" end-to-side ureteral anastomosis with robotic endoscopic technique in radical cystectomy (RC) and urinary diversion (UD) in elderly and obese patients with bladder cancer. MATERIALS AND METHODS: We retrospectively reviewed the records of 10 patients with bladder cancer who underwent robot-assisted laparoscopic radical cystectomy and ""Y-shaped"" end-to-side ureteral anastomosis under general anesthesia at Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China, 310014) from October 2018 to January 2021. Demographic and clinical data are summarized. The incidence of postoperative complications such as papillary retraction, ureteral stricture, anastomotic stenosis, anastomotic fistula and ureteral calculi were observed and analyzed. RESULTS: A total of 10 elderly and obese patients successfully underwent RC with ""Y-shaped"" end-to-side ureteral anastomosis in this research. Median age was (80.6 ± 5.7) y and BMI was (25.12 ± 3.83) kg/m(2). The operation time was (95 ± 26) min and the estimated intraoperative blood loss was (100.5 ± 35.6) ml, with no perioperative blood transfusion and no readmission 30 days after operation. No serious complications above Clavien-Dindo grade 4 occurred in the early (≤ 30 d) and late (> 30 d) after surgery. 1 patient developed fever three days after operation and was cured by strengthening anti-infection. 1 patient had a small amount of urine leakage at the anastomotic site after operation, and recovered after strengthening nutrition and maintaining the patency of abdominal drainage tube and single J tube. Postoperatively, the patients replaced the single J tube regularly and were followed up for 3-28 months (average 15 months) until April 10, 2021. In two cases, the ureterostomy nipple was slightly retracted and collapsed without special treatment. one case formed ureteral calculi and was treated conservatively. No ureteral stenosis, necrosis, anastomotic stenosis or severe anastomotic fistula, hernia around the stoma occurred. No visceral metastases or new lesions of urothelial carcinoma were observed. All patients were satisfied with the postoperative quality of life. CONCLUSIONS: The robot-assisted ""Y-shaped"" end-to-side ureteral anastomosis technique performed intracorporeally seems to be a straightforward, secure, and viable approach. It is considered suitable for radical resection of bladder cancer and urinary diversion in elderly and obese patients."	bladder